Social Engagement Among Older Adults With Mild Cognitive Impairment and Conversion to Dementia

Promoting social engagement is a promising approach to prevent or delay conversion from cognitive impairment no dementia (CIND) to dementia. However, little is known about social engagement among people with CIND. This dissertation project aimed to improve understanding of social engagement among people with CIND by addressing gaps in the literature. It had three specific aims including: to describe and identify factors associated with heterogeneity of social engagement among older adults with CIND, to assess the association between heterogeneity of social engagement and conversion from CIND to dementia, and to investigate the relationship among heterogeneity of social engagement, other types of activity engagement, and conversion from CIND to dementia. Data from two waves (2010 and 2014) of the Health and Retirement Study (HRS) were used. The sample consisted of 1,227 people who were classified as having CIND in 2010. To identify the heterogeneity of social engagement, Latent Class Analysis (LCA) was utilized. Multinomial logistic regression analysis was conducted to assess the association between factors and patterns of social engagement. Using LCA, three groups were identified: Formal and informal social engagement group, Informal social engagement only group, and Low social engagement group. Some factors from four domains of WHO’s ICF model were associated with probability of having certain patterns of social engagement. To assess the relationship between heterogeneity of social engagement and conversion from CIND to dementia, binary logistic regression was utilized. The result showed that people in the formal and informal social engagement group and informal social engagement only group had significantly lower probabilities of converting to dementia in four years. To investigate the relationship among different types of activity engagement and conversion from CIND to dementia, path analysis with structural equation model was utilized. The result revealed that the relationship between having the pattern of formal and informal social engagement and lower probability of converting to dementia in four years was mediated by having higher cognitive engagements. Findings suggest that social engagement is heterogeneous among people with CIND and there are some modifiable factors to promote social engagement among them. Results of this study also imply that promoting social engagement may be promising intervention to prevent or delay conversion from CIND to dementia. Findings further indicate that promoting social engagement may be more effective and efficient strategy since it promotes other activity engagements that may prevent or delay conversion from CIND to dementia

No evidence for a recent genetic bottleneck in the endangered Sheko cattle breed (African Bos taurus) revealed by microsatellite analysis

Sheko is African taurine cattle, valued for its milk yield, adaptation to humid tsetse infested environment and trypanotolerance. We used 30 microsatellite markers in analyzing 30 DNA samples. We found high genetic diversity and no genetic bottlenecks in endangered Sheko cattle. Sheko cattle have not undergone recent genetic bottlenecks, in spite of drastic reduction in its overall demographic population size. The results were supported by three statistical methods: 
(i) detection of heterozygosity excess 
(ii) a mode-shift indicator of allele distribution pattern 
(iii) the ratio of the number of alleles to the range of allele size, M-ratio test. This breed reflects historical and cultural identity of local communities and represents a unique component of the global domestic animal biodiversity that deserve priority for conservation

Successful lung lobectomy for a lung cancer following thoracic endovascular aortic repair for a thoracic aortic aneurysm: report of a case

Lung cancer and a thoracic aortic aneurysm were detected simultaneously in a 79-year-old male patient with diabetes. The aneurysm was first treated by thoracic endovascular aortic repair. A right lower lobectomy was subsequently performed after the blood flow of the bronchial and intercostal arteries was confirmed by computed tomographic angiography. The bronchial stump was covered with an intercostal muscle flap. The patient's postoperative course was uneventful. Thoracic endovascular aortic repair is a useful and less invasive treatment for such cases, but a blood flow evaluation of the aortic branches should be done following this procedure before a lung resection is considered.ArticleSURGERY TODAY. 44(5):940-943 (2014)journal articl

The Role of Echocardiography in the Management of Patients Undergoing a Ventricular Assist Device Implantation and/or Transplantation

Heart transplantation (HTx) is a curative treatment for patients with advanced heart failure (HF); however, since transplant opportunities are severely limited due to donor shortage, the left ventricular assist device (LVAD) has become a standard therapy for patients awaiting HTx. The role of echocardiography as a primary imaging modality to monitor the allograft function in transplant recipients as well as to optimize LVAD settings in LVAD recipients has been expanding. The purpose of this review is to highlight the clinical role of echocardiography in the management of patients undergoing LVAD implantation and/or HTx. In particular, we overview (1) how to detect LVAD malfunction and device-associated complication in LVAD recipients and (2) echocardiographic assessments of cardiac allograft rejection in transplant recipients

Associations between volunteering and cognitive impairment: The moderating role of race/ethnicity

Article describes how although volunteering has been shown to benefit cognitive health, there is a paucity of evidence on informal volunteering and subjective measures of cognitive impairment. The author's study aimed to examine the associations of both formal and informal volunteering with older adults' objective and subjective cognition and explore the moderating role of race/ethnicity in such associations

Trials for Risk Assessment of Japanese Encephalitis Based on Serologic Surveys of Wild Animals

Flavivirus Encephaliti

Eating-related distress and need for nutritional support of families of advanced cancer patients: A nationwide survey of bereaved family members

Background: A number of advanced cancer patients are suffering from physical and psychosocial burdens because of cancer cachexia, and these burdens also greatly impact on their family members and relationships between patients and family members. It is necessary to consider the psychosocial impact of cancer cachexia on family members of advanced cancer patients. Methods: A cross-sectional anonymous nationwide survey was conducted involving 925 bereaved family members of cancer patients who had been admitted to 133 inpatient hospices throughout Japan. Results: A total of 702 bereaved family members returned the questionnaires (response rate, 75.9%). Concerning eating-related distress, 'I served what the patient wanted without consideration of calories and nutritional composition' was highest (75.1%), and 'I tried making many kinds of meals for the patient' and 'I was concerned about planning meals for the patient every day' followed (63.0% and 59.4%, respectively). The top 5 of the 19 items were categorized as 'fighting back'. Need for nutritional support was high (72.2%), and need for explanations about the reasons for anorexia and weight loss of patients was moderate (41.4%). Explanatory factor analysis of eating-related distress identified the following four domains: (factor 1) feeling that family members forced the patient to eat to avoid death, (factor 2) feeling that family members made great efforts to help the patient eat, (factor 3) feeling that eating was a cause of conflicts between the patient and family members, and (factor 4) feeling that correct information was insufficient. Results of multiple logistic regression analysis showed that spouse, fair/poor mental status, factors 1, and 4 were identified as independent determinants of major depression (odds ratio [OR] 3.27 [95% confidence interval (CI) 1.24-8.60], P=0.02; OR 4.50 [95% CI 2.46-8.25], P<0.001; OR 2.51 [95% CI 1.16-5.45], P=0.02; OR 2.33 [95% CI 1.13-4.80], P=0.02, respectively). Conclusions: A number of family members of advanced cancer patients experienced high levels of eating-related distress and had a need for nutritional support

Modulation of cortisol responses to the DEX/CRH test by polymorphisms of the interleukin-1beta gene in healthy adults

<p>Abstract</p> <p>Background</p> <p>Recently, hypothalamus-pituitary-adrenal (HPA) axis function assessed with the combined dexamethasone (DEX)/corticotropin releasing hormone (CRH) test has been shown to be associated with response to antidepressant treatment. A polymorphism (rs16944) in the interleukin-1beta (<it>IL-1β</it>) gene has also been reported to be associated with the medication response in depression. These findings prompted us to examine the possible association between <it>IL-1β </it>gene polymorphisms and HPA axis function assessed with the DEX/CRH test.</p> <p>Methods</p> <p>DEX/CRH test was performed in 179 healthy volunteers (45 males: mean age 40.5 ± 15.8 years; 134 females: mean age 47.1 ± 13.2 years). Five tagging single nucleotide polymorphisms (SNPs) of <it>IL-1β </it>gene (rs2853550, rs1143634, rs1143633, rs1143630, rs16944) were selected at an r²threshold of 0.80 with a minor allele frequency > 0.1. Genotyping was performed by the TaqMan allelic discrimination assay. A two-way factorial analysis of variance (ANOVA) was performed with the DEX/CRH test results as the dependent variable and genotype and gender as independent variables. To account for multiple testing, <it>P </it>values < 0.01 were considered statistically significant for associations between the genotypes and the cortisol levels.</p> <p>Results</p> <p>The cortisol levels after DEX administration (DST-Cortisol) showed significant associations with the genotypes of rs16944 (<it>P </it>= 0.00049) and rs1143633 (<it>P </it>= 0.0060), with no significant gender effect or genotype × gender interaction. On the other hand, cortisol levels after CRH administration (DEX/CRH-Cortisol) were affected by gender but were not significantly influenced by the genotype of the examined SNPs, with no significant genotype × gender interaction.</p> <p>Conclusions</p> <p>Our results suggest that genetic variations in the <it>IL-1β </it>gene contribute to the HPA axis alteration assessed by DST-Cortisol in healthy subjects. On the other hand, no significant associations of the <it>IL-1β </it>gene polymorphisms with the DEX/CRH-Cortisol were observed. Confirmation of our findings in futures studies may add new insight into the communication between the immune system and the HPA axis.</p